Brit J Hosp Med
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Current best practice in placement of arterial lines is to attempt to cannulate the radial artery in the first instance. However, if the radial artery is difficult to cannulate there is no consensus among clinicians on how best to proceed. This article looks at the evidence for the different options.
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This article summarises the findings from a review of publications related to healthcare leadership that were published during the first wave of the COVID-19 crisis in 2020. The review discusses a range of strategies for leaders to adopt in challenging situations and identifies three aspects of leadership which are considered essential when leading teams during a crisis: 1) communication, 2) decision making and 3) mental health and wellbeing. This article identifies key principles for each of these three aspects and provides practical tips for how leaders can use the lessons learned from the pandemic in their own contexts.
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Hand fractures are the most common fractures of the upper extremity, with a reported incidence of 3.7 per 1000 per year for men and 1.3 per 1000 per year for women. Understanding the diagnosis and management of these injuries is vital for any clinician working in the emergency department, plastic or orthopaedic surgery or providing community care. This review identifies the most common presentations and outlines how to assess and manage such fractures appropriately, with an emphasis on clinical and radiographic examination. The majority of hand fractures are managed conservatively and operative management should be carefully considered on a case-by-case basis with analysis of patient and fracture-related factors, in order to achieve optimal hand function following treatment.
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This article reports on the career choice of foundation doctors going through a local foundation programme and whether they planned to take an F3 year. The authors also prospectively gathered views relating to their career choice and the need for an F3 year. ⋯ The local picture in terms of trainees taking an F3 option reflects the national trend. Some trainees find foundation training a stressful time and so need to be offered support. The authors comment on the factors that make a career appealing to trainees.
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The hand is an extremely versatile organ adapted for fine tasks with various clinicoanatomical compartments. This article reviews the types of common hand infections that present to the emergency department and/or hand surgeon, with relevant investigations and strategies for diagnosis and treatment, with the emphasis on distinguishing between superficial and more serious infections.